Clinical Studies involving Mesenchymal Stem Cells: A 2020 Review

There are more than 240,000 scientific publications published on "stem cell' on the National Library of Medicine (PubMed). As of August 2020, more than 7,500 studies have been launched to investigate the potential of stem cell therapy under the U.S. Clinical Trial Registry. This review aims to explain what a mesenchymal stem cell is and the evidence available on it's use in various clinical disorders.
Stem Cell Research Summary

Stem cell therapy has gained popularity as a promising treatment option for conditions where the current medical treatment protocols have been exhausted. However, there is also a lot of confusion due to the overwhelming mixing of credible scientific information and marketing hypes available on the internet.

Another reason for the confusion is the lack of understanding of the subject itself. Further, there are many types of stem cells, many sources of stem cells, many methods to process the stem cells, many ways of administering the stem cells and many conditions that are suitable for stem cell therapy. If you are new to stem cells, check out stem cell basics.

What are Mesenchymal Stem Cells?

There are mainly two types of naturally occurring stem cells found in a human body, Hematopoietic Stem Cells (HSCs) and Mesenchymal Stem Cells (MSCs). Hematopoietic stem cells are found in cord blood, bone marrow and peripheral blood. MSCs are found in Wharton's jelly (refer to image below), bone marrow, fat tissue and tooth pulp.

Umbilical Cord

The umbilical cord itself is a rich source of stem cells, where its Wharton’s Jelly holds precious Mesenchymal Stem Cells (MSCs). These stem cells have been found to be very promising as it has beneficial properties that Hematopoietic Stem Cells (HSCs) may have restrictions in. MSCs have the ability to differentiate into bone, heart, nerve, cornea, fat and cartilage cells, and has been used for repairs of these organs. In the lab, it can be used to expand HSCs to make umbilical cord blood stem cells transplant available even to adults. 

Compared to ESCs (Embryonic Stem Cells) and iPSCs (induced Pluripotent Stem Cells), mesenchymal stromal cells (MSCs) isolated from umbilical cords are relatively safer for clinical use as they pose very low risk of cancer formation [J Transl Med, 2011Tissue Eng Regen Med, 2019].

CLINICAL PUBLICATIONS INVOLVING MESENCHYMAL STEM CELLS (MSCs)

Just on UC-MSC (Umbilical Cord derived Mesenchymal Stem Cells) alone, there were 178 registered clinical trials and 98 publications about cell therapy that employ UC-MSC, for the years 2007–2017. How do we keep up with all these stem cell therapy evidence?

There was 178 registered clinical trials and 98 publications about cell therapy that employ Umbilical Cord derived Mesenchymal Stem Cells (UC-MSC), for the years 2007–2017 (Regenerative Medicine, 2019).

Here, we have listed and compiled significant scientific publications related to mesenchymal stem cell therapy. The list was complied by running various searches on PubMed. Each study is hyperlinked to the abstract in the U.S. National Library of Medicine or the full text article to make it easier for healthcare providers or scientists to access more details. The list was complied by running various searches on PubMed.

In order to make it consumer friendly, we have tried to summarise the studies and minimise the technical jargons so that a layperson can understand.

This list is a work-in-progress list as new evidence might be added from time to time. Here is the list by clinical disorder.

Diabetes Mellitus Type 1 and Type 2

J. Hu, X. Yu, Z. Wang, F. Wang, L. Wang, H. Gao, et al.
No. of patients: 29
Results: HbA1c, postprandial blood glucose and daily insulin dosage reduced.C-peptide improved.

J. Hu, Y. Wang, H. Gong, C. Yu, C. Guo, F. Wang, et al.
No. of patients: 61
Results: Postprandial plasma glucose, HbA1c, daily insulin and oral hypoglycemic drugs intake and incidence of DM complications reduced. Fasting C-peptide and β-cells function improved.

Liver Failure and Liver Cirrhosis

M. Shi, Z. Zhang, R. Xu, H. Lin, J. Fu, Z. Zou, et al.
No. of patients: 43
Results: Survival rate increased. Liver function improved.

Z. Zhang, H. Lin, M. Shi, R. Xu, J. Fu, J. Lv, et al.
No. of patients: 45
Results: Liver function improved.

Spinal Cord Injury

H. Cheng, X. Liu, R. Hua, G. Dai, X. Wang, J. Gao, et al.
No. of patients: 34
Results: 7/10 patients treated with WJ-MSCs showed improvement in movement, self-care ability and muscular tension.

J. Liu, D. Han, Z. Wang, M. Xue, L. Zhu, H. Yan, et al.
No. of patients: 22
Results: 13/16 of patients with 'incomplete' SCI (spinal cord injury) responded to the treatment. 6/6 patients with 'complete' SCI showed no response.

Heart Attack and Heart Failure

X.F. Zhao, Y. Xu, Z.Y. Zhu, C.Y. Gao, Y.N. Shi
No. of patients: 59
Results: Heart function improved and 6-minutes walking distance improved. Mortality rate reduced.

L.R. Gao, Y. Chen, N.K. Zhang, X.L. Yang, H.L. Liu, Z.G. Wang, et al.
No. of patients: 116
Results: Heart injury size reduced. Heart function improved.

SLE (System Lupus Erythematosus)

D. Wang, J. Li, Y. Zhang, M. Zhang, J. Chen, X. Li, et al.
No. of patients: 40
Results: SLEDAI score, BILAG score and renal function improved. Serum anti-dsDNA antibody and anti-nuclear antibody reduced.

Multiple Sclerosis

J.-F. Li, D.-J. Zhang, T. Geng, L. Chen, H. Huang, H.-L. Yin, et al.
No. of patients: 23
Results: Disease progression slowed down. Shifting of Th1 to Th2 immunity.


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